Five-level cervical corpectomy for neurofibromatosis-associated spinal deformity: case report

Scott L. Parker*, Jean Paul Wolinsky, Anthony P. Tufaro, Ziya L. Gokaslan, Timothy F. Witham

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Purpose: To describe a successful five-level cervical corpectomy and circumferential reconstruction in a patient with a plexiform neurofibroma causing a severe kyphotic deformity. Methods: Case report. Results: 43-year-old man with history of Neurofibromatosis presented with signs and symptoms of myelopathy with spastic lower extremities and gait difficulties. Imaging studies demonstrated a severe kyphotic deformity of the cervical spine with associated cord compression secondary to an anteriorly positioned plexiform neurofibroma. Two-stage surgical procedure was designed to treat this lesion. Stage I consisted of tracheostomy placement, transmandibular, circumglossal approach to the anterior cervical spine, C2–C6 corpectomies, and C1–C7 reconstruction with a custom titanium cage/plate. Stage II consisted of suboccipital craniectomy, C1–C2 laminectomies, and occipital-cervical thoracic instrumented fusion (O-T8). There were no operative complications, but the patient did develop a small pulmonary embolism post-operatively treated with anticoagulation. Patient required two-weeks of inpatient rehabilitation following surgery. Gastrostomy tube and tracheostomy were successfully discontinued with preserved swallowing and respiratory function. Patient-reported outcome measurements revealed significant and sustained improvement post-operatively. Conclusions: Five-level cervical corpectomy including C2 can be safely and successfully performed via a transmandibular, circumglossal approach. Circumferential reconstruction utilizing a custom anterior titanium cage and plate system manufactured from a pre-operative CT scan was utilized in this case. Long segment occipital-cervical-thoracic reconstruction is recommended in such a case. Using such a technique, improvement in myelopathy, correction of deformity, and improved quality of life can be achieved.

Original languageEnglish (US)
Pages (from-to)544-550
Number of pages7
JournalEuropean Spine Journal
Volume24
DOIs
StatePublished - May 1 2015

Keywords

  • Cervical deformity
  • Corpectomy
  • Neurofibromatosis
  • Transmandibular, circumglossal approach

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Five-level cervical corpectomy for neurofibromatosis-associated spinal deformity: case report'. Together they form a unique fingerprint.

Cite this